Summer 2013

SUMMER 2013 | SANFORDHEALTH.ORG

A Bold New Approach

to Breast Cancer

discoveries Spring 2013

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Message from Gene Hoyme A Bold New Approach to Breast Cancer Updates from Development & Research World Clinic Patient Impact Grows

message

from Gene Hoyme, MD

Sanford Health Development & Research 1305 W 18th Street PO Box 5039 Sioux Falls, SD 57117-5039 For questions or additional information email us at discoveries@sanfordhealth.org or visit us on the web at sanfordhealth.org

As you can see in this issue of Sanford Discoveries, our Edith Sanford Breast Cancer Research team is gaining significant momentum, demonstrated by key national partnerships and the implementation of the program’s first clinical trial for patients. Sanford Research recruited world-renowned physician and breast cancer researcher, Dr. Brian Leyland-Jones, just one year ago from the Winship Cancer Institute at Emory University. This has allowed our breast cancer research program to accelerate and become quickly established both nationally and within the Sanford Health system. In addition to leading our breast cancer research program, patients can access Dr. Leyland-Jones’ experience and expertise through a second-opinion breast cancer clinic at Sanford.

You will find that breast cancer research is just one of many important Sanford Research and Development programs making a meaningful impact on the Sanford Health system and future of healthcare.

Gene Hoyme, MD President, Sanford Research Chief Academic Officer, Sanford Health

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a bold new approach to breast cancer If you look closely at the distinctive logo of Edith Sanford Breast Cancer, you’ll see that it says a lot about what this unique initiative is all about.

awareness, and it also forms an “S,” in honor the dynamic leadership of Sanford Health that allows Edith Sanford to speed discoveries to patients and communities.

The double helix signifies Edith Sanford’s dedication to pushing the boundaries of genomics research to quickly find the cures. One of the strands is depicted as a pink ribbon, the iconic symbol of breast cancer

Altogether, the logo represents a comprehensive, multifaceted initiative, with outside-the-box thinking, that will ultimately elevate the standard of breast cancer care for women and men everywhere.

new supporters. A limited release campaign recently aired nationwide spotlighting Edith Sanford’s lifesaving research and featuring South Dakota native and TV celebrity, Mary Hart, the Foundation’s national spokesperson.

Fargo Sanford Oncologist Shelby Tierstrip, MD, champions Sanford’s Embrace cancer survivorship program and is a contributor to “DeCoded,” the new Edith Sanford blog.

The ambitious Edith Sanford Breast Cancer Research program, led by world-renowned physicianscientist Dr. Brian Leyland-Jones, will use whole genome sequencing to pinpoint the mutations in DNA that drive different types of breast cancer. In turn, that insight will inform treatment strategies that can precisely target the culprit behind each individual patient’s cancer and stop the tumor growth. This approach is central in Edith Sanford’s mission to shift the conventional one-size-fits-all treatment paradigm to one that focuses on the unique profile of each person.

Over the last year, Dr. LeylandJones and the growing Edith Sanford Breast Cancer Research team have worked tirelessly to assemble the infrastructure and multidisciplinary expertise needed to carry out this sophisticated research and translate discoveries to patients. Included in their arsenal are the latest hightech sequencing technologies and a bioinformatics team skilled at interpreting vast amounts of genomic data. A cornerstone is Edith Sanford’s growing biobank—an extensive repository of critical blood and tissue samples that gives scientists ready access to genetic material needed for breast cancer studies.

This array of tools and resources is also available to other institutions in Edith Sanford’s expanding breast cancer genomics network.

Collaboration and data sharing with scientific luminaries such as The Scripps Research Institute, a partnership announced last fall, are recognized as key to knocking down silos and

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speeding the research process.

The faster lifesaving discoveries can be made, the faster they can be delivered directly to patients through Edith Sanford Breast Health. The patient care arm of Edith Sanford reaches thousands of women and men across the region, providing 65,700 mammography screenings each year. Its dedicated and expert doctors, nurses and other professionals provide complete care for breast disease and offer a full range of state-of-the-art services.

This bold, accelerated approach to breast cancer is gaining momentum from supporters across the country.

Through a robust online presence, events, and ongoing mail and email communications, the Edith Sanford Breast Cancer Foundation has already raised more than $1 million from thousands of grassroots donors.

Original events such as Suit Up to Stop Breast Cancer, where groups and individuals create water-based challenges and ask sponsors to pledge funds, have helped raise awareness and support for the cause—and the Foundation has more planned for the months ahead. In particular, keep your eyes open in June for the launch of Team Edith™, a platform that will promote healthy lifestyles and provide a variety of new opportunities to support the Foundation. Other events and programs are in the works that feature collaborations with corporate sponsors like the Minnesota Timberwolves and the Lynx, Julep, CH Patisserie, DelMo Sports and Arena North America.

Currently, the Foundation is also using television to engage

Most importantly, 100 percent of every dollar raised through the Foundation’s efforts is invested directly in finding the cures. Faster.

This is possible thanks to the transformational gift from Denny Sanford, made in honor of his mother Edith, that launched the Edith Sanford Breast Cancer initiative.

Please join the Edith Sanford Breast Cancer Foundation in making its vision to eradicate breast cancer a reality. For more information or to get involved, follow Edith Sanford through social media (facebook. com/edithsanfordbreastcancer and twitter.com/edithsanford) or visit edithsanford.org.

DeCoding Breast Cancer The Edith Sanford Breast Cancer Foundation is proud to introduce its new blog, DeCoded.

DeCoded is about sparking a new line of conversation about breast cancer and providing trustworthy advice, as well as fresh insights and perspectives about the fight against breast cancer. It brings together experts like lead contributor, Dr. Shelby Terstriep, a Fargo oncologist and survivorship specialist, to decode the breast cancer experience and explore topics in unexpected ways.

Most importantly, DeCoded is about building a community of people who, like all of us, are just trying to make sense of this disease one day at a time.

Join the conversation at teamedith.org/community.

updates

Sioux Falls Pediatric Geneticist, Gene Hoyme, MD (also President of Sanford Research and Chief Academic Officer for Sanford Health), examines a patient as a Sanford/USD medical student looks on.

Sanford Research New Clinical Molecular Genetics Laboratory Underway

Sanford Health BioBank Update

Megan Landsverk, PhD, has been hired as the Director of Sanford Research’s new Clinical Molecular Genetics Laboratory. Dr. Landsverk is currently in a similar role at Baylor University Medical Center in Houston and will begin at Sanford Research this summer. Sanford’s new molecular genetics laboratory is more advanced than most large universities, including on-site capabilities in exome and whole genome sequencing. Sanford is currently pursuing CLIA (Clinical Laboratory Improvement Amendments) certification from the Centers for Medicare and Medicaid Services.

At the Sanford BioBank, the cancer panel has been validated and is available for use on Ion Torrent sequencing equipment, and the team is evaluating the comprehensive cancer panel (409 genes) and inherited disease panel (300-plus genes representing over 700 inherited diseases) for use on the equipment. The next generation of equipment, the Ion Proton was installed in January, and BioBank staff are evaluating it for use in exome sequencing. The first exome run was completed with 5.5 gigabases (5 billion) of sequence captured.

Work continues in order to refine techniques to increase throughput.

Sanford Health has a long history of providing genetic services across the Dakotas. Sanford employs four physician/MD geneticists, along with a team of genetic counselors at its Sioux Falls and Fargo campuses. Sanford houses the only Clinical Cytogenetics Laboratory in North and South Dakota and provides clinical genetics services to the states of South and North Dakota, with clinic sites in Fargo, Sioux Falls, Pierre and Rapid City.

The new Clinical Molecular Genetics Laboratory will be an important adjunct to the care of genetics patients of all ages throughout the Upper Midwest.

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the direction of Executive Director, Michael Bergeron, PhD, and Associate Director, Thayne Munce, PhD, initiated a study to further investigate balance testing as an effective concussion evaluation tool.

Sioux Falls Sanford Health Vascular Surgeon Patrick Kelly, MD, is creating a patented device for improving endovascular treatment of aortic aneurysms.

Office of Commercialization: Kelly Advances New Innovation

treatments and help advance research surrounding their disease.

As a former engineer, Sanford Health Vascular Surgeon Patrick Kelly, MD, is naturally passionate about designing. Recently, he partnered with Sanford Frontiers to commercialize a vision he has for improving endovascular treatment of aortic aneurysms. His patented device would treat thoraco abdominal aneurysms in a minimally invasive way. He believes that the innovative approach could decrease hospital length of stay while also improving incidence rates for several devastating complications, such as paraplegia, renal failure, and death.

Sanford has more than 150 open trials and more than 350 ongoing clinical studies. Additional opportunities for patients to participate in research at Sanford include the Sanford Health BioBank and Coordination of Rare Diseases at Sanford (CoRDS) registry.

Dr. Kelly is currently planning a clinical trial that would require an investigational device exemption (IDE) from the FDA. The study would test safety and efficacy of the device, and could support a premarket approval (PMA) application.

If results are promising and the device receives FDA approval, the team could partner with a major medical device manufacturer to fabricate and distribute the device for wider use.

Centralized Clinical Trials Website Launched Patients interested in participating in research can now access clinical trial information by visiting sanfordhealth.org/ClinicalTrials.

The comprehensive tool was created to help potential participants easily identify trials they may enroll in to gain access to innovative 6 | discoveries

Seed Grant Update: Concussion Research Progresses The number of children and young adults seeking medical care for sports concussions has risen considerably in recent years. Proper concussion management Verle Valentine, and decisions about a MD, Sanford Sports Medicine patient’s return to play Concussion Specialist are crucial, because potential subsequent brain trauma can be more severe or even catastrophic, if the initial injury has not resolved.

Physicians charged with making initial diagnoses and subsequent return-to-play determinations can enhance their quality of care by utilizing multiple screening tools to comprehensively evaluate their patients. Balance testing is a relatively new method and evolving technique in the evaluation of concussions that warranted further investigation. As a 2011 Sanford Research Seed Grant recipient, Sanford Sports Medicine Concussion Specialist Verle Valentine, MD and researchers at Sanford’s National Institute for Athletic Health and Performance (NIAHP), under

Currently, the study has enrolled 205 individuals who have suffered head trauma and a resultant concussion and 26 non-concussed athletic individuals as control subjects. The diagnostic value of a novel balance testing protocol using dual-task interference from a concomitant cognitive challenge and longitudinal data from this and other standard clinical concussion assessment tools were examined. The research teams’ findings indicated that balance testing including a cognitive challenge is more revealing of postural instability and may uniquely assist healthcare providers in making more objective and appropriate return-to-play and unrestricted physical and cognitive activity determinations, as well as return-to-school decisions for the student-athlete.

The findings have been presented at national and international conferences, including the 2012 American College of Sports Medicine Annual Meeting and 2012 4th International Consensus Conference on Concussion in Sport in Zurich.

The primary manuscript of the findings, lead-authored by Jason Dorman, Operations Manager at the NIAHP, is currently under review by a scientific journal for publication consideration.

Promising Batten Disease Therapy Discovered A team from Sanford Research has discovered a potentially promising therapy for reducing the degenerative effects of Batten disease. Sanford Research’s Jake Miller, Chun-Hung Chan, PhD, and David Pearce, PhD, authored the study, “The role of nonsensemediated decay in neuronal ceroid lipofuscinosis,” recently published in Human Molecular Genetics.

All three researchers are members

of the Pearce Lab for Genetically Inherited Diseases of Children, which primarily explores Batten disease.

caused by loss of function in the part of the brain, the cerebellum, which serves as the coordination center.

Batten disease, most commonly found in children, is a group of neurodegenerative diseases that result in seizures, blindness, motor and cognitive decline and premature death. It is caused by mutations in at least 14 different genes that result in a lack of the normal gene product, or protein. The mutations often pre-dispose the gene product to premature decay, known as nonsense-mediated decay (NMD).

CoRDS is a national rare disease registry designed to accelerate research into rare conditions. The program collects and stores basic contact and clinical information on individuals of any age who have been diagnosed with a rare disease (undiagnosed individuals are also eligible for enrollment).

Miller, Chan and Pearce found that by chemically blocking NMD in cells, the gene product and thus protein levels are increased, suggesting that the cellular consequences of the mutation can be corrected. Further studies will address whether this approach can be harnessed to slow the degenerative symptoms of Batten disease.

Led by Pearce, who also serves as chief operating officer and vice president of Sanford Research, the Pearce Lab for Genetically Inherited Diseases of Children is globally known for its research of Batten disease. Pearce has studied the genetic disorder for more than a decade.

NAF is a membership supported, non-profit organization that was established in 1957 to help persons with ataxia and their families. Its primary purpose is to support promising ataxia research and to provide vital programs and services for ataxia families. It is the largest organization dedicated to all forms of hereditary and sporadic ataxia in the country.

Ataxia is a group of often fatal degenerative neurological disorders which affects an estimated 150,000 people in the United States. Ataxia can be classified as sporadic or genetic. Sporadic ataxia has no known genetic link or family history.

Sporadic ataxia, which is acquired, results from an external cause such as vitamin deficiencies, autoimmune conditions, infections, exposure to toxic substances or drugs and various cancers. Genetic ataxia is due to inherent damage in a person’s DNA.

Rare Disease Symposium Attracts Over 400

Sanford Research Chief Operating Office and Vice President, David Pearce, PhD, is globally known for his discoveries in Batten disease.

National Ataxia Foundation (NAF) Partners with CoRDS The Coordination of Rare Diseases at Sanford (CoRDS) will host NAF’s ataxia patient registry to help advance research of all forms of the disease.

Ataxia creates difficulties with balance and coordination and is typically

Seven rare disease experts from across the US, including two from Sanford, drew in more than 400 people for the Third Annual Sanford Rare Disease Symposium Feb. 28-March 1 at the Sanford Center. Guest speakers included scientists and leaders from Oregon Health and Sciences University Hospital, Shriner’s Hospital Portland, Children’s Hospital of Philadelphia, Parent Project Muscular Dystrophy, University of California at San Diego School of Medicine, and SanfordBurnham Medical Research Institute.

of Rare Diseases at Sanford (CoRDS), the event was a nod to the Feb. 28 recognition of Global Rare Disease Day and featured experts from across the country.

Sanford Senior Genetic Counselor Quinn Stein, MS, CGC, opened the symposium Thursday evening with his presentation, “A Day in the life of a (Sanford) Genetic Counselor.”

Sanford Research Chief Operating Officer and Vice President David Pearce, PhD, closed the two-day event with “Autoimmunity in Batten Disease: From Bench to Clinical Trial.” Pearce is also the director of the Sanford Children’s Health Research Center.

Sioux Falls Sanford Senior Genetic Counselor Quinn Stein, MS, CGC, opened Sanford’s Third Annual Rare Disease Symposium.

Sanford Program for Undergraduate Research (SPUR) Receives Grant Sanford Research was notified it will be awarded a National Science Foundation grant to support a Research Experiences for Undergraduates (REU) in Cellular and Molecular Biology. The REU program will run alongside and augment Sanford Research’s SPUR program, providing a platform for attracting graduate students that would not normally apply to Sanford’s affiliated program at the University of South Dakota.

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Sanford Research Team Members Recognized Congratulations to Dr. Kristi Egland and Elizabeth McMillan for their nominations in the EmBe (Empowering You to Be) Annual Tribute to Women awards program (formerly YWCA). This annual recognition celebrates the talent, achievement, imagination and innovation of local women who have made an exemplary contribution in the workplace and in the community. This year’s 40th anniversary celebration was held April 25, 2013 at the Washington Pavilion in Sioux Falls.

Deb Langstraat, director of the human research protection program at Sanford, was selected to serve on the National Cancer Institute Central IRB Local Site Advisory Panel.

Research in Dr. Michael Kruer’s lab was featured in an article for the Cerebral Palsy Foundation’s “Reaching for the Stars” to promote Cerebral Palsy Awareness Month.

Collaborative Research Center for American Indian Health Holds First Annual Summit The inaugural Collaborative Research Center for American Indian Health (CRCAIH) Annual Summit was held June 11-12 at the Sanford Center.

The Summit included national speakers, panel discussions and Brian Leyland-Jones, MB BS, PhD, is the Director of Edith Sanford Breast Cancer Research

training on topics, including community engagement in research, regulatory knowledge and research ethics.

Last year, Sanford Research’s Center for Health Outcomes and Prevention, led by Amy Elliott, PhD, and its partners received a $13.5 million grant—the largest to date—from the National Institute on Minority Health and Disparities to create CRCAIH. Its goal is to bring together tribal communities and health researchers from multiple disciplines to address health disparities experienced by American Indians in South Dakota, North Dakota and Minnesota.

The project includes the Cheyenne River Sioux Tribe and Oglala Sioux Tribe (Pine Ridge). Partners also include South Dakota State University; the University of South Dakota; the University of North Dakota; North Dakota State University; Turtle Mountain Community College; Missouri Breaks, Inc.; Medicine Wheel, Inc.; Rapid City Regional; and Children’s Hospitals and Clinics of Minnesota.

Edith Sanford Breast Cancer Research National Bioinformatics Expert Joins Sanford Research Scooter Willis, PhD has joined the Edith Sanford Breast Center Research Team and is a specialist in computer science and engineering, with expertise in the genomic analysis of expression data from nextgeneration sequencing. Dr. Willis plays a vital role in Edith Sanford’s bioinformatics program and in facilitating the scientific partnership between Edith Sanford and The Scripps Research Institute, which was announced in November 2012.

Before joining Edith Sanford Breast Cancer Research, he worked as a data analysis scientist for the genomics core at The Scripps Research Institute in Jupiter, Florida. Dr. Willis earned his PhD in computer engineering at the University of Florida with

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a research focus in information theory. He also holds a Master of Engineering, a Master of Business Administration with emphasis on entrepreneurship for engineers and scientists, and a Bachelor of Science from the University of Florida.

Edith Research Team will Offer First Trial The Edith Sanford Breast Cancer Research team will soon launch the SSKT Clinical Trial, spearheaded

by Director of Edith Sanford Breast Cancer Research Dr. Brian LeylandJones. Patients with metastatic breast cancer who have no immediate matching therapy will be eligible to participate. Patients will be recruited at Sanford Health and Sanford partner, Scripps Health, based out of San Diego. In summary, the trial involves sequencing the genomes of 25 patients, and searching for specific genetic markers that can result in highly targeted treatments.

A second group of 100 to 150 patients will be eligible for enrollment following the initial cohort of 25.

Scripps Research Institute (based out of Florida and California), will process the core whole genome sequencing and analyze the data.

The genomic profiling will reveal targeted treatments that can potentially enhance the best practice standard of care by further retarding tumor growth. The genetic analysis and recommended therapy will be submitted as a recommendation to the patient’s tumor board (a group of multidisciplinary practitioners charged with treating the patient).

The process, from beginning to end, is estimated to take three weeks.

Additional clinical trials are under development. Edith Sanford Breast Cancer Research is also researching biomarkers in over 3,000 DNA samples from patients with breast cancer from several medical centers throughout the country, with a similar goal of determining therapeutic targets based on genetic variation in the tumors.

Morgan Sorensen of Lincoln High School in Sioux Falls was a 2012 Sanford PROMISE Scholar.

PROMISE: Program for the Midwest Initiative in Science Exploration Sanford Research Announces 2013 PROMISE Scholars, Fellows Eight Sioux Falls area high school students and eight regional educators have been selected by Sanford Research as PROMISE scholars and science educator fellows for 2013.

The Sanford PROMISE Scholars Program offers regional high school students the chance to complete research projects in mentor laboratories at Sanford Research during the summer between their junior and senior years. Students receive hands-on training in biomedical techniques and ethics, and develop projects that will impact research conducted in their mentor’s lab. This year’s selections are from six different high schools: • Erin Buse, Brandon Valley High School • Kelvin Chow, Dakota Valley High School • Kimberly Chow, Dakota Valley High School • Brooklyn DeVries, Harrisburg High School

•E rin Eickman, McCook Central High School

• Jamie Tucker, Sioux Valley School District

•S kyla Neuharth, Harrisburg High School/Sioux Falls CTE Academy

• Jeff Schneider, Armour School District

•Z arin Rahman, Brookings High School

The Sanford PROMISE Scholars Program, overseen by Elizabeth McMillan, is in its third year, while this is Dr. Peter Vitiello’s second year coordinating the Science Educator Research Fellowship Program.

• J oshua Reider, TriValley High School The Science Educator Research Fellowship Program supports heath research performed by middle and high school science teachers with a focus on pediatrics. During the summer, participants conduct independent community-based or biomedical research under the supervision of a Sanford scientist and receive inquiry-based instruction to support the translation of their research experience into the classroom. Educators for 2013 hail from six different schools:

High-school students participate in a handson Discovery Day activity.

•S teve Ortmeier, Sioux Falls Lincoln High School •C asey Rose, Sioux Falls Lincoln High School •L aura Mehlbrech, Sioux Falls Washington High School •M ichael Amolins, Harrisburg High School •A ngel Wachal, Harrisburg High School •T iffany Kroeger, Montrose Middle and High School

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Discovery Day Continues The 5th Sanford PROMISE Science Discovery Days held on April 17 hosted approximately 150 regional high school students from New Tech High School, Parker High School, Rutland High School, and Sioux Valley High School (South Dakota), Spencer High School (Iowa), and a group of local home school students. The goal of the Discovery Days program is to engage and motivate students in STEM (Science, Technology, Engineering and Mathematics) careers.

Scientists from Sanford Research and throughout the region shared their careers and academic backgrounds with students through hands-on activities. Additionally, professors, educators, coordinators, and others from regional universities and programs hosted interactive booths to further incite interest in science tracks. The Discovery Days program opens students’ eyes to the wide variety of careers associated with scientific research and development.

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Childhood Nutrition and Fitness Initiatives: fit fit Continues to Make Impact Pilots and programs integrating fit in schools continue to mature, making the following impact: • The fit-Club is now being piloted in six clubs in five schools engaging more 150 girls; • The fit4schools pilot is currently in three schools reaching approximately 500 kids; • A fit for PROMISE session (a collaboration with The Sanford PROMISE) included more than 1,000 regional students; and • The fit4theClassroom program with Discovery Education closed its sweepstakes with over 18,000 entries from all 50 states.

Though the numbers continue to grow, direct response received by the Sanford fit team is the most dynamic in reaching both children and families through these innovative programs. A first-grade teacher using the fit4schools program recently shared that several parents mentioned fit during parent-teacher conferences.

They talked about how much kids enjoy the activities and talk about it at home.

Sanford Research and Development Executive Vice President Ruth Krystopolski participates in a Ghana site visit (top left photo).

Sanford World Clinic World Clinic Patient Impact Grows Sanford World Clinic has now supported in excess of 130,000 patient visits. Collectively, Sanford staff has provided nearly 80,000 patient visits from July 2012 through March 2013. The Ghana clinics represent approximately 50 percent of this volume while celebrating the organization’s first-year anniversary of providing care in Africa.

The Cape Coast, Ghana clinic is seeing in excess of 1,200 patients per week with 3.5 physicians in support.

The team continues work to achieve accreditation with the national health insurance scheme for new facilities in Kojokrom, Adenta and Mankassim, with full approval expected later this year. The World Clinic team has identified the fifth Ghana clinic location, Kasoa. Construction for this location will begin in October with a targeted opening in May of next year.

Physician Liaison Program Extends Sanford Home-base Expertise Sanford World Clinic is launching a new program to bring the full expertise and experience of Sanford Health physicians to its World Clinic sites. The World Clinic Liaison Program is an opportunity for Sanford Health pediatricians and

family practice physicians to travel to and collaborate with one of Sanford’s seven World Clinic locations.

This two-year assignment includes a seven-day site visit along with monthly teleconference collaboration.

The program is designed to encourage physicians to interact with Sanford World Clinics to learn from each other and share best practices, as well as partner on practice challenges.

Two Sanford Health physicians have been selected this year to participate, including:

Suzanne Human, MD, Bemidji Sanford Health Family Medicine

Scott McKercher, MD, Sioux Falls Sanford Pediatrician

•D r. Suzanne Human, a Sanford Health family medicine physician in Bemidji, will travel to and collaborate with one of the Sanford World Clinic Ghana, Africa sites.

•S cott McKercher, a Sanford Health pediatrician in Sioux Falls, will travel to and collaborate with World Clinic sites in both Duncan, Oklahoma and Ghana, Africa.

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events

give.

July 13: 2013 American Diabetes Association Tour de Cure

2013 ADA Tour de Cure, Saturday, July 13, Sanford Center

Join Team Sanford for the ADA Tour de Cure Join Sanford’s Dr. John Shelso, and hundreds of riders from around the region, for the 2013 American Diabetes Association Tour de Cure. This important event will begin and end with celebrations at the Sanford Center on Saturday, July 13. With 8, 25 and 50 mile loops on great country roads north of Sioux Falls, this annual ride appeals to those who ride a single-speed cruiser or those preparing for next year’s professional Paris-Roubaix classic!

Register at: diabetes.org/toursouthdakota October 11: Sanford Genetics and Genomic Medicine Symposium * Unless otherwise noted, all events will be located at the Sanford Center, 2301 East 60th Street North, Sioux Falls, SD 57104 12 | discoveries

If you are interested in providing philanthropic support for any of the research or major initiatives featured in this publication, please contact the Sanford Health Foundation. Thank you.

Sioux Falls Region: (605) 328-5700 Fargo Region: (701) 234-6246 Bismarck Region: (701) 323-8450 Bemidji Region: (218) 333-5515 foundation.sanfordhealth.org Edith Sanford Breast Cancer Foundation: (855) 463-3484 edithsanford.org